lid eversion

eversion, lid

Turning of the eyelid inside out so as to expose the palpebral conjunctiva. For the upper lid this is accomplished by grasping the lid by the central eyelashes, pulling it downward and forward and then folding it back over a cotton applicator (or thin plastic rod) placed at the upper margin of the tarsus, while the patient continually maintains downward fixation. Return to the normal lid position is obtained by asking the patient to look up and gently pushing the eyelashes in an outward and downward direction. Foreign bodies and even contact lenses are often lodged under the upper eyelid or in the conjunctival fornix of the upper eyelid. To inspect the superior conjunctival fornix double lid eversion is necessary. Following lid eversion (and usually with local anaesthesia of the conjunctiva), a retractor is placed between the two skin surfaces of the lid with the retractor engaging the tarsus and, after gently pulling outward and upward, the fornix will become visible. Eversion of the lower lid is performed easily by drawing the margin downward while the patient looks upward. See .